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Elders with hypothyroidism require lower doses of levothyroxine for replacement than do younger people. However, many elders are overtreated and, as a result, develop iatrogenic hyperthyroidism — a risk factor for fracture. In this case-control study, investigators assessed the effects of levothyroxine dose on fracture risk among 214,000 Canadians (age, ≥70; mean age, 82) who were prescribed levothyroxine between 2002 and 2007.
After average follow-up of 3.8 years, 22,000 participants (88% women) experienced fractures. When remote levothyroxine use (stopped >180 days before index date) was used for comparison, current use and recent past use (stopped within 15–180 days of index date) were associated with significantly elevated risks for frac…